scholarly journals Development and validation of Malaysia Medication Adherence Assessment Tool (MyMAAT) for diabetic patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241909
Author(s):  
Ernieda Hatah ◽  
Nadiah Rahim ◽  
Mohd Makmor-Bakry ◽  
Noraida Mohamed Shah ◽  
Noraini Mohamad ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Assessment Tool ◽  
Medication Possession Ratio ◽  
Subjective Assessment ◽  
Diabetic Patients ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Adherence Assessment ◽  
The Face ◽  
Final Item

Medication non-adherence remains a significant barrier in achieving better health outcomes for patients with chronic diseases. Previous self-reported medication adherence tools were not developed in the context of the Malaysia population. The most commonly used tool, MMAS-8, is no longer economical because it requires a license and currently every form used is charged. Hence, there is a need to develop and validate a new medication adherence tool. The Malaysia Medication Adherence Assessment Tool (MyMAAT) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. The face and content validities of the MyMAAT was established by a panel of experts. A total of 495 patients with type 2 diabetes were recruited from the Ministry of Health facilities consisting of five hospitals and five primary health clinics. A test-retest was conducted on 42 of the patients one week following their first data collection. Exploratory factor analysis was performed to evaluate the validity of the MyMAAT. The final item for MyMAAT was compared with SEAMS, HbA1c%, Medication Possession ratio (MPR) score, and pharmacist’s subjective assessment for its hypothesis testing validity. The MyMAAT-12 achieved acceptable internal consistency (Cronbach’s alpha = 0.910) and stable reliability as the test-retest score showed good to excellent correlation (Spearman’s rho = 0.96, p = 0.001). The MyMAAT has significant moderate association with SEAMS (Spearman’s rho = 0.44, p = < 0.001) and significant relationship with HbA1c (< 8% and ≥ 8%) (χ2(1) = 13.4, p < 0.001), MPR (χ2(1) = 13.6, p < 0.001) and pharmacist’s subjective assessment categories (χ2(1) = 31, p < 0.001). The sensitivity of MyMAAT-12, tested against HbA1c% was 72.9% while its specificity was 43%. This study demonstrates that the MyMAAT-12 together with other methods of assessment may make a better screening tool to identify patients who were non-adherence to their medications.

scholarly journals Pengaruh Dukungan Sosial Terhadap Kecemasan Pada Ibu Hamil di Puskesmas Jetis Kabupaten Ponorogo

2018 ◽  
Vol 5 (1) ◽  
pp. 55-66
Author(s):  
Ambika Kurnia Mustikawati
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Correlation Coefficient ◽  
Sampling Technique ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
The Social ◽  
The Face ◽  
Independent Variable

Background: Pregnancy is a valuable thing, but also one of the great stresses for awoman both physically and mentally. Pregnant women with high anxiety will increase therisk of hypertension, difficulty sleeping and stroke, seizures and even death in the motherand fetus. In Puskesmas Ponorogo district the number of pregnant women as much as5903 mothers, while in health centers Jetis the number of pregnant women as many as200 mothers. Interview results, 21 out of 27 mothers said were very anxious during herpregnancy. The purpose of this study was to analyze the factors of social support foranxiety in pregnant women.Subjects and Methods: The type of research is analytical with cross-sectional approach.The location of research at Jetis health center Ponorogo regency. Research conducted onSeptember 1 to October 15, 2016. Sample of 30 pregnant women using proportionalrandom sampling technique. Dependent variable is anxiety, while independent variable issocial support. Data collection techniques using questionnaires. Data analysis usingSpearman's Rho using SPSS 18.0 for windows computer program.Results: The results showed that from 40 respondents, almost half were 13 (32.5%)multiparous had mild anxiety and nearly half were 13 (32.5%) primipara experiencedmoderate anxiety. of the 40 respondents, nearly half (12%) of 3 trimester pregnantwomen had moderate anxiety and a small proportion of 9 (22.5%) of 2 trimester pregnantwomen had mild anxiety. The result of calculation using spearman's rho statistic testobtained p = 0,006 <α 0,05 mean there is influence between parity with anxiety inpregnant woman with correlation coefficient of -0,424 which show intensity of influenceof medium that is if the smaller parity hence more anxiety level. The calculation ofgestational age with spearman's rho p = 0,023 <α 0.05 means that there is an influencebetween parity with anxiety in pregnant women with a correlation coefficient of 0.359which shows the weakness of weak influence.Conclusion: The social support provided by husband and family will affect the level ofanxiety in each pregnant woman. It is hoped for a place of research to provide a solutionfor pregnant women who experience anxiety so that pregnancy can run smoothly andrespondents are expected to have a good coping mechanism in the face of anxiety forhealth and also the fetus.

scholarly journals Adherence and quality of life among diabetic patients with hypertension

2018 ◽  
Vol 8 (1) ◽  
pp. 14 ◽  
Author(s):  
Akrom Akrom ◽  
Wima Anggitasari
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Treatment Adherence ◽  
Average Score ◽  
Bivariate Analysis ◽  
Diabetic Patients ◽  
Adherence Assessment ◽  
High Level ◽  
College Educated

<p><span>The level of treatment adherence and quality of life are not known in diabetic patients with hypertension. The study aim was to evaluate the level of adherence and quality of life of diabetic patients with hypertension in Bantul Public Hospital (BPH), Bantul, Indonesia.</span><span>This</span><span> study used a Cross-sectional method by conducting a survey through a direct interview with the patient. Participants of this study were 143 diabetic patients with hypertension in the internal disease clinic of BPH. Modified Morisky Medication Adherence Scale was used to measure the level of treatment adherence and SF36 questionnaires were used to measure the quality of life. Descriptive and analytical statistical was performed on data from the adherence assessment, quality of life, demographic characteristic and the clinical condition of the research participant. Bivariate analysis with </span><span lang="IN">C</span><span>hi-square was performed to assess the relationship between demographic and clinical factors to the high level of adherence. The majority of respondents had moderate and low levels of adherence. There were 34 patients (23.78%) with a high level of adherence, 56 patients (39.16%) with moderate level of adherence, and 53 patients (37.06%) with low level of adherence. Respondents also had low quality of life, in which the average score of quality of life was 61.96±12.48. Male and college-educated patients have higher adherence (OR&gt;1, p&lt;0.05) compared to other groups. Medication adherence and quality of life of diabetic patients with hypertension in BPH were relatively low. Male and high college-educated patients were associated with high levels of adherence</span></p>

The Face-Symbol Test and the Symbol-Digit Test are not reliable surrogates for the Paced Auditory Serial Addition Test in multiple sclerosis

2006 ◽  
Vol 12 (5) ◽  
pp. 599-604 ◽  
Author(s):  
J Williams ◽  
K O’Rourke ◽  
M Hutchinson ◽  
N Tubridy
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Cognitive Testing ◽  
Alternative Methods ◽  
Functional Composite ◽  
Multiple Sclerosis Functional Composite ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
The Face ◽  
Serial Addition

The Paced Auditory Serial Addition Test (PASAT) is the chosen task for cognitive assessment in the multiple sclerosis functional composite (MSFC) and a widely used task in neuropsychological studies of people with multiple sclerosis (MS), but is unpopular with patients. The Face-Symbol Test (FST) and Symbol-Digit Tests (SDT) are alternative methods of cognitive testing in MS, which are easily administered and patient-friendly. In order to evaluate the potential of the FST as a possible surrogate for the PASAT, we directly compared the FST to the PASAT and the SDT in a cohort of 50 MS patients with varying levels of disability. There was significant correlation between SDT and FST scores (Spearman’s rho 0.80, 95% CI 0.66 - 0.88), R2 65%, with moderate inter-test agreement (κ = 0.52). In contrast, SDT and FST scores were less predictive of PASAT scores. We concluded that neither the FST nor SDT are reliable surrogates for the PASAT.

scholarly journals Self-reported health literacy and medication adherence in older adults: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056307
Author(s):  
Moritz Sebastian Schönfeld ◽  
Stefanie Pfisterer-Heise ◽  
Corinna Bergelt
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Health Literacy ◽  
Quality Assessment ◽  
Assessment Tool ◽  
Medication Possession Ratio ◽  
Cochrane Library ◽  
Quantitative Methodology ◽  
Cross Sectional ◽  
Reported Health

ObjectivesTo give an overview over the associations between self-reported health literacy and medication adherence in older adults.DesignA systematic literature review of quantitative studies published in English and German.Data sourcesMEDLINE via PubMed, CINAHL, Cochrane Library, Epistemonikos and LIVIVO were searched.Eligibility criteriaIncluded studies had to examine the associations between self-reported health literacy and medication adherence in the elderly (samples including ≥66% of ≥60 years old) and had to use a quantitative methodology and had to be written in English or German.Data extraction and synthesisAll studies were screened for inclusion criteria by two independent reviewers. A narrative synthesis was applied to analyse all included studies thematically. Quality assessment was conducted using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.ResultsWe found 2313 studies, of which nine publications from eight studies were included in this review. Five studies reported a majority of participants with limited health literacy, one study reported a majority of participants with adequate health literacy, and three publications from two studies only reported mean levels of health literacy. Eight publications from seven studies used self-reports to measure medication adherence, while one study used the medication possession ratio. Overall, six publications from five studies reported significantly positive associations between health literacy and medication adherence while two studies reported positive but non-significant associations between both constructs and one study reported mixed results.ConclusionIn this review, associations between self-reported health literacy and medication adherence are rather consistent, indicating positive associations between both constructs in older adults. However, concepts and measures of health literacy and medication adherence applied in the included studies still show a noteworthy amount of heterogeneity (eg, different use of cutoffs). These results reveal the need for more differentiated research in this area.PROSPERO registration numberCRD42019141028.

Evaluation of the Modified Naranjo Criteria for Assessing Causal Attribution of Clinical Outcome to Homeopathic Intervention as Presented in Case Reports

Homeopathy ◽  
2020 ◽  
Vol 109 (04) ◽  
pp. 191-197
Author(s):  
Chetna Deep Lamba ◽  
Vishwa Kumar Gupta ◽  
Robbert van Haselen ◽  
Lex Rutten ◽  
Nidhi Mahajan ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Causal Relationship ◽  
Clinical Case ◽  
Assessment Tool ◽  
Causal Attribution ◽  
Case Reports ◽  
Face Validity ◽  
Rater Agreement ◽  
The Face ◽  
Selection Of

Abstract Objectives The objective of this study was to establish the reliability and content validity of the “Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory” as a tool for attributing a causal relationship between the homeopathic intervention and outcome in clinical case reports. Methods Purposive sampling was adopted for the selection of information-rich case reports using pre-defined criteria. Eligible case reports had to fulfil a minimum of nine items of the CARE Clinical Case Reporting Guideline checklist and a minimum of three of the homeopathic HOM-CASE CARE extension items. The Modified Naranjo Criteria for Homeopathy Inventory consists of 10 domains. Inter-rater agreement in the scoring of these domains was determined by calculating the percentage agreement and kappa (κ) values. A κ greater than 0.4, indicating fair agreement between raters, in conjunction with the absence of concerns regarding the face validity, was taken to indicate the validity of a given domain. Each domain was assessed by four raters for the selected case reports. Results Sixty case reports met the inclusion criteria. Inter-rater agreement/concordance per domain was “perfect” for domains 1 (100%, κ = 1.00) and 2 (100%, κ = 1.00); “almost perfect” for domain 8 (97.5%, κ = 0.86); “substantial” for domains 3 (96.7%, κ = 0.80) and 5 (91.1%, κ = 0.70); “moderate” for domains 4 (83.3%, κ = 0.60), 7 (67.8%, κ = 0.46) and 9 (99.2%, κ = 0.50); and “fair” for domain 10 (56.1%, κ = 0.38). For domains 6A (46.7%, κ = 0.03) and 6B (50.3%, κ = 0.18), there was “slight agreement” only. Thus, the validity of the Modified Naranjo Criteria for Homeopathy tool was established for each of its domains, except for the two that pertain to direction of cure (domains 6A and 6B). Conclusion The Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory was identified as a valid tool for assessing the likelihood of a causal relationship between a homeopathic intervention and clinical outcome. Improved wordings for several criteria have been proposed for the assessment tool, under the new acronym “MONARCH”. Further assessment of two MONARCH domains is required.

scholarly journals POS0584 ULTRASONOGRAPHY OF THE MEDIAN NERVE IN PATIENTS WITH RHEUMATOID ARTHRITIS UNDER SUSPICION OF CARPAL TUNNEL SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 525.1-525
Author(s):  
S. Tsiami ◽  
E. Ntasiou ◽  
C. Krogias ◽  
R. Gold ◽  
J. Braun ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction Velocity ◽  
Sectional Area ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Tunnel Syndrome

Background:Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome and a common extra-articular manifestation of rheumatoid arthritis (RA). Different causes of CTS are known, among them inflammatory and non-inflammatory pathologies. Electroneurography (ENG) of the median nerve, the method of choice to diagnose CTS, measures impairment of nerve conduction velocity without explaining its underlying cause. However, because the electrical stimulation is often not well tolerated, ENG results may come out inconclusive. Using greyscale ultrasonography (GS-US) provides anatomic information including a structural representation of the carpal tunnel.Objectives:To investigate the performance of nerve GS-US in the diagnosis of CTS in patients with RA.Methods:Consecutive patients with active RA under suspicion of CTS presenting to a large rheumatologic center were included. Both hands were examined by an experienced neurologist including ENG and a GS-US (ML linear probe with 6-15 Hz) of the median nerve. An established grading system for ENG (1), and an established system for GS-US based on cut-offs for the nerve cross sectional area (CSA) [mild: 0,11-0,13cm2, moderate: 0,14-0,15 cm2, severe: > 0,15 cm2 CTS (2)] were used. In addition, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) was used to assess CTS symptoms (3).Results:Both hands of 58 patients with active RA (n=116) and clinical suspicion of CTS (in 38 cases bilaterally) were included. After clinical examination, CTS was suspicious in 96 hands (82.8%), and 59 of all hands had a final diagnosis of CTS (50.9%). Of the latter, 43 hands (72.9%) had a positive ENG and 16 (27.1%) a positive GS-US finding only, while 30 hands (50.8%) were positive in both examinations.There was a good correlation of the cross-sectional area (CSA) as well as the CSA-ratio to the ENG findings: the larger the CSA, the more severe was the CTS as assessed by ENG (Spearman’s rho=0.554; p<0.001). The more severe the GS-US findings of CTS were, the more definite were the distal motor latency (Spearman’s rho=0.554; p<0.001) and sensible nerve conduction velocity of the median nerve (Spearman’s rho=-0.5411; p<0.001).In the 46 hands positive in GS-US, tenosynovial hypertrophy of the flexor tendons was detected in 19 hands (41.3%), 7 of which (36.8%) also showed an additional cystic mass. In these 19 patients, clinical complains were more severely present than in patients with non-inflammatory CTS, as assessed by the BCTSQ with a total score of 68.8±13.4 vs. 59.3±13.7, respectively (p=0.007).Conclusion:In patients with active RA and clinical complains of CTS, ultrasound examinations provide additional information about inflammation which is helpful for a diagnosis of CTS. Thus, ENG and nerve GS-US should be used complementary for a diagnostic workup of CTS in RA patients with a suspicion of CTS. Power-Doppler may further improve the diagnostic performance of GS-US.References:[1]Padua L et al. Acta Neurol Scand 1997; 96:211–217[2]El Miedany et al., Rheumatology (Oxford). 2004 Jul; 43(7):887-895[3]Levine DW et al. J Bone Joint Surg Am 1993; 75: 1585-1592Figure 1.BCTSQ scores in patients with diagnosis of CTS and absence or presence of RA-related tenosynovial hypertrophyDisclosure of Interests:None declared

Factors affecting thyroid volume in adolescent students attending a rural middle school in East Hangzhou, China

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Qiaoyong Liu ◽  
Yiqian Jiang ◽  
Lijun Shen ◽  
Jiming Zhu
Keyword(s):  
Middle School ◽  
Middle School Students ◽  
Growth And Development ◽  
Univariate Analysis ◽  
Thyroid Volume ◽  
Physical Development ◽  
School Students ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Rural Middle School

AbstractObjectiveTo investigate the thyroid volume (Tvol) and to explore factors that affects it among 12 to 15-year-olds attending a rural middle school in east Hangzhou, China.MethodsA cross-sectional survey of middle school students attending a rural middle school in east Hangzhou, China was conducted. Height, weight and other physical development related indicators in middle school students were measured. The thyroid size was measured using ultrasound, and the thyroid volume calculated.ResultsThe median (P25, P75) of the thyroid volume in 596 middle school students from a rural middle school in east Hangzhou, China was 6.69 (5.66, 7.98) mL. Our study enrolled 305 male students (51.2%) and 291 female students (48.8%). The height, weight and thyroid volume of middle school students increased with age. Univariate analysis revealed that height, weight, body mass index (BMI) and body surface area (BSA) were positive correlated with thyroid volume (p<0.01).The correlation between BSA and thyroid volume was significant (Spearman’s rho=0.473, p<0.01). Multiple linear regression analysis revealed that BSA was positive and significantly correlated with the thyroid volume (p<0.05). Regression equation was Y=−2.532 + 6.186×BSA.ConclusionThe thyroid volume is not only affected by age, but it is also affected by growth and development. Goiter cannot only be assessed based on age, gender and thyroid volume. However, this study established that BSA not only presented the strongest correlation with thyroid volume (Spearman’s rho=0.473), but also had a strong correlation with physical development, taking into account the growth and development of middle school students, and showed greater stability. Therefore, we recommend inclusion of BSA as a reference standard in the measurement of the thyroid volume.

Alterations of serum levels of plasminogen, TNF-α, and IDO in granulomatosis with polyangiitis patients

Vascular ◽  
2021 ◽  
pp. 170853812098630
Author(s):  
Dobroslav Kyurkchiev ◽  
Tsvetelina Yoneva ◽  
Adelina Yordanova ◽  
Ekaterina Kurteva ◽  
Georgi Vasilev ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Necrosis Factor Alpha ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Tnf Α ◽  
Spearman’S Rho

Background Granulomatosis with polyangiitis (GPA) is a representative of vasculitides associated with anti-neutrophil cytoplasmic autoantibodies. “Classical” antibodies directed against proteinase 3 are involved in the pathogenesis and are part of the GPA diagnosis at the same time. Along with them, however, antibodies against Lysosomal-Associated Membrane Protein-2 (LAMP-2) and antibodies directed against plasminogen have been described in GPA. Objectives and methodology: We performed a cross-sectional study enrolling 34 patients diagnosed with GPA. Our study was aimed at looking for correlations between serum levels of LAMP-2 and plasminogen and the clinical manifestations of the GPA. Furthermore, we examined serum levels of tumor necrosis factor-alpha (TNF-α) and its associated indoleamine-pyrrole 2,3-dioxygenase (IDO), as well as we looked for a correlation between these cytokines and the clinical manifestations of GPA. Results The results showed that in GPA, serum plasminogen levels were negatively associated with renal involvement (receiver operating characteristic (ROC) area under the curve (AUC) of 0.78) (95% CI 0.53–0.91), p = 0.035, and the extent of proteinuria, Spearman’s Rho = –0.4, p = 0.015. Increased levels of TNF-α and IDO correlated with disease activity, Spearman’s Rho =0.62, p = 0.001 and Spearman’s Rho = 0.4, p = 0.022, respectively, whereas only TNF-α was increased in severe forms of GPA with lung involvement (ROC AUC of 0.8) (95% CI 0.66–0.94), p = 0.005. Conclusions In this study, we demonstrate the alteration of soluble factors, which play an important role in the pathogenesis of GPA and their relationship with the clinical manifestations of the disease. Our main results confirm the associations of increased secretory TNF-α and some clinical manifestations, and we describe for the first time decreased serum plasminogen levels and their association with renal involvement.

scholarly journals Validity and reliability testing of the Toddler and Infant (TANDI) Health Related Quality of Life instrument for very young children

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Janine Verstraete ◽  
Lebogang Ramma ◽  
Jennifer Jelsma
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Validity And Reliability ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Related Quality ◽  
Health Related ◽  
Six Dimensions ◽  
The Impact

Abstract Background Despite the high burden of disease in younger children there are few tools specifically designed to estimate Health Related Quality of Life (HRQoL) in children younger than 3 years of age. A previous paper described the process of identifying a pool of items which might be suitable for measuring HRQoL of children aged 0–3 years. The current paper describes how the items were pruned and the final draft of the measure, Toddler and Infant (TANDI) Health Related Quality of Life, was tested for validity and reliability. Methods A sample of 187 caregivers of children 1–36 months of age were recruited which included children who were either acutely ill (AI), chronically ill (CI) or from the general school going population (GP). The TANDI, an experimental version of the EQ-5D-Y proxy, included six dimensions with three levels of report and general health measured on a Visual Analogue Scale (VAS) from 0 to 100. The content validity had been established during the development of the instrument. The TANDI, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolabilty (FLACC) or Neonatal Infant Pain Scale (NIPS) and a self-designed dietary information questionnaire were administered at baseline. The TANDI was administered 1 week later in GP children to establish test-retest reliability. The distribution of dimension scores, Cronbach’s alpha, rotated varimax factor analysis, Spearman’s Rho Correlation, the intraclass correlation coefficient, Pearson’s correlation, analysis of variance and regression analysis were used to explore the reliability, and validity of the TANDI. Results Concurrent validity of the different dimensions was tested between the TANDI and other instruments. The Spearman’s Rho coefficients were significant and moderate to strong for dimensions of activity and participation and significant and weak for items of body functions. Known groups were compared and children with acute illness had the lowest ranked VAS (median 60, range 0–100), indicating worse HRQoL. The six dimensions of the TANDI were tested for internal consistency and reliability and the Cronbach’s α as 0.83. Test-retest results showed no variance for dimension scores of movement and play, and high agreement for pain (83%), relationships (87%), communication (83%) and eating (74%). The scores were highly correlated for the VAS (ICC = 0.76; p < 0.001). Conclusion The TANDI was found to be valid and reliable for use with children aged 1–36 months in South Africa. It is recommended that the TANDI be included in future research to further investigate HRQoL and the impact of interventions in this vulnerable age group. It is further recommended that future testing be done to assess the feasibility, clinical utility, and cross-cultural validity of the measure and to include international input in further development.

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